Individual
SHANNON MARIE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
5 WEST MAIN STREET, CROSBY, MN 56441
(218) 546-7333
(218) 546-7334
Mailing address
5 WEST MAIN STREET, CROSBY, MN 56441
(218) 546-7333
(218) 546-7334
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
003141
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3C156GA
BLUE CROSS/BLUE SHIELD
MN
Enumeration date
11/13/2006
Last updated
07/08/2007
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